Gving all the meds all at once? - page 6

I've been working as Nurse in LTC for 2 months now. Woot. I'm just concerned about the ways of other Nurses who gives all the meds for 5pm and 9pm all at once? Is that bad? I asked one of the... Read More

  1. by   Jo Dirt
    Quote from ingelein
    LTC administrators will not ever be eating out of the hand of the nurses, LTCs have substandard care because the nurse /patient ratio is based on PROFIT and GREED. How about the title of the article on this forum, "Dont Blame the Nurse, Fix the System."
    THANK YOU.
  2. by   Spidey's mom
    Quote from ingelein
    What?!Do you mean to say that there is unsafe staffing in LTC and other places as you said, BECAUSE we dont do a proper job as professionals, please tell me I misunderstood you. You dont see a corellation between poor staffing and corporate greed? Maybe you dont.
    This blame the nurse mentality and accepting this type of reasoning, as good little nursies has kept us working in facilities that have substandard nurse/ patient ratios.

    So what was it that improved nurse/ patient ratios in California? I bet it wasnt being perfect/ subordinate nurses, it was nurses who were DEDICATED enough and had the guts to fight for a better workplace.
    You did misunderstand me.

    I am complaining about "perfect/subordinate nurses" who fudge the timing of meds against regulations and safe practice.

    I also completely realize that "facilities" want to lessen the cost of doing business and unfortunately this usually falls on the reason we are all there - patient care. It happened where I used to work when our fabulous DON left and was replaced by a number cruncher.

    Just because I comment on people who won't stand up to administration doesn't mean I don't think administration has perfect motives.

    I've been a nurse for 9 years and it has always bothered me when the "status quo" continues because that is the way it has always been done . ..even though it is wrong.

    steph
    Last edit by Spidey's mom on Dec 22, '07
  3. by   Simplepleasures
    Quote from stevielynn
    You did misunderstand me.

    I am complaining about "perfect/subordinate nurses" who fudge the timing of meds against regulations and safe practice.

    I also completely realize that "facilities" want to lessen the cost of doing business and unfortunately this usually falls on the reason we are all there - patient care. It happened where I used to work when our fabulous DON left and was replaced by a number cruncher.

    Just because I comment on people who won't stand up to administration doesn't mean I don't think administration has perfect motives.

    I've been a nurse for 9 years and it has always bothered me when the "status quo" continues because that is the way it has always been done . ..even though it is wrong.

    steph
    Maybe you misunderstood Daytonites post.I dont think she blames nurses in LTC for the poor nurse/patient ratio, does she? Or does she think that if we are perfect nurses LTC will eat out of our hands? Clarification?
    Last edit by Simplepleasures on Dec 22, '07
  4. by   Spidey's mom
    Quote from daytonite
    the standards are in the middle? what does that mean? the standards are there to be followed, not bent and re-interpreted to what we think they mean. i think that it's this kind of thinking that has contributed to any substandard care in ltc. working in ltc doesn't mean it's ok to lower the standards. those who do lower them allow for facilities to get away with hiring more people who will do the same! if we all stood our ground and followed the standards to the letter then the administrators of facilities would be eating out of our hands. as long as there are nurses who are willing to cut corners and compromise the standards, they will make it difficult for those of us who want to stay happily employed in these places.
    i do agree with it . . . it is this kind of thinking that has allowed substandard care in ltc . . .along with the fact that the powers-that-be try to save money by hiring fewer nurses and increasing the amount of patients per each nurse, so some nurses feel they have to cut corners to get their job done, instead of standing up and saying no.

    both the nurse and the "powers" are at fault.

    steph
    Last edit by Spidey's mom on Dec 22, '07
  5. by   Simplepleasures
    Quote from stevielynn
    I do agree with it . . . it IS this kind of thinking that has allowed substandard care in LTC . . .along with the fact that the powers-that-be try to save money by hiring fewer nurses and increasing the amount of patients per each nurse, so SOME nurses feel they have to cut corners to get their job done.

    Both the nurse and the "powers" are at fault.

    steph
    I think the substandard care is based on the nurse patient ratio , I think nurses in LTC want to be able to do a job that they can be proud of every night, not one in which they come home sick to their stomachs from worry something didnt get done.I worked in LTC for 30 years, I still have the scars to show for it, some are not physical.
  6. by   Spidey's mom
    Quote from ingelein
    I think the substandard care is based on the nurse patient ratio , I think nurses in LTC want to be able to do a job that they can be proud of every night, not one in which they come home sick to their stomachs from worry something didnt get done.I worked in LTC for 30 years, I still have the scars to show for it, some are not physical.
    I really don't want to make this personal. You have extensive experience in LTC and have your own story to tell. I respect that.

    From my perspective, when I worked LTC as a "float", I did not pre-pour or give all the meds at once. It took me a long time to pass my meds (being new and having many patients). If I was late, I wrote the reason why, inadequate staffing. I wasn't floated there very often.

    My question is, WHY put up with this? Why give 5 p.m. and 9 p.m. meds at 5 p.m. and then lie on the MAR? Why not work with the doc and pharmacy to reschedule meds? Why take a job in the first place where the staffing is so unsafe? Why stay at a job like that?

    I think the substandard care may start with the staffing arrangements of the "powers" but the nurses who put up with it have some culpability too.

    steph
  7. by   Simplepleasures
    Quote from stevielynn
    I really don't want to make this personal. You have extensive experience in LTC and have your own story to tell. I respect that.

    From my perspective, when I worked LTC as a "float", I did not pre-pour or give all the meds at once. It took me a long time to pass my meds (being new and having many patients). If I was late, I wrote the reason why, inadequate staffing. I wasn't floated there very often.

    My question is, WHY put up with this? Why give 5 p.m. and 9 p.m. meds at 5 p.m. and then lie on the MAR? Why not work with the doc and pharmacy to reschedule meds? Why take a job in the first place where the staffing is so unsafe? Why stay at a job like that?

    I think the substandard care may start with the staffing arrangements of the "powers" but the nurses who put up with it have some culpability too.

    steph
    Maybe I need to clarify here, I dont advocate prepouring or giving all meds at once, I am trying to get the point across that these things may be done by some BECAUSE of Nurse/Patient ratios and untenable workload, doesnt make it right, but is a symtom of a VERY SICK system. Again, dont blame the nurse fix the system.
    Last edit by Simplepleasures on Dec 22, '07
  8. by   Spidey's mom
    Quote from ingelein
    Maybe I need to clarify here, I dont advocate prepouring or giving all meds at once, I am trying to get the point across that these things may be done by some BECAUSE of Nurse/Patient ratios and untennable workload, doesnt make it right, but is a symtom of a VERY SICK system. Again, dont blame the nurse fix the system.
    Well, I don't agree that the nurse who puts up with it (and/or who cuts corners) doesn't have to share the blame of allowing a broken system to continue. Paraphrasing the quote below - No one can make you work in a place with a very sick system without your consent.

    "No one can make you feel inferior without your consent" Eleanor Roosevelt

    Gonna have to agree to disagree here. :flowersfo

    steph
  9. by   Simplepleasures
    Quote from stevielynn
    Well, I don't agree that the nurse who puts up with it (and/or who cuts corners) doesn't have to share the blame of allowing a broken system to continue. Paraphrasing the quote below - No one can make you work in a place with a very sick system without your consent.

    "No one can make you feel inferior without your consent" Eleanor Roosevelt

    Gonna have to agree to disagree here. :flowersfo

    steph
    I have seen nurses who do prepour and give meds all at once, and ,they are the so called perfect nurses because they get their work done on time, they are LOVED by administration. Guess what happens to nurses in LTC that try to help fix the sytem, who refuse to do illegal/ unethical practices? They get fired in retaliation, nurses without protection, either by state or union have no voice, cant fix anything without the tools. Its OK if we disagree, at least there is a discussion about WHY these things happen in LTC and that can help bring about needed changes in LTC. I never felt inferior by the way.
    Last edit by Simplepleasures on Dec 22, '07
  10. by   jackson145
    Quote from ingelein
    I have seen nurses who do prepour and give meds all at once, and ,they are the so called perfect nurses because they get their work done on time, they are LOVED by administration. Guess what happens to nurses in LTC that try to help fix the sytem, who refuse to do illegal/ unethical practices? They get fired in retaliation, nurses without protection, either by state or union have no voice, cant fix anything without the tools. Its OK if we disagree, at least there is a discussion about WHY these things happen in LTC and that can help bring about needed changes in LTC. I never felt inferior by the way.
    It sounds like you've worked at my place. Anyone who even mentions that something might need changed gets labeled as a trouble maker. Even if they are doing it against "the rules", they ones who get done on time are the blessed ones. The ones who sacrifice their health and sanity to play by the rules end up being forced out by the powers that be. I've seen this at a lot of places. It's really sad that it has to be that way.
  11. by   Spidey's mom
    Quote from ingelein
    I have seen nurses who do prepour and give meds all at once, and ,they are the so called perfect nurses because they get their work done on time, they are LOVED by administration. Guess what happens to nurses in LTC that try to help fix the sytem, who refuse to do illegal/ unethical practices? They get fired in retaliation, nurses without protection, either by state or union have no voice, cant fix anything without the tools. Its OK if we disagree, at least there is a discussion about WHY these things happen in LTC and that can help bring about needed changes in LTC. I never felt inferior by the way.
    Re: "inferior" . . . that is why I paraphrased it . . . .I'm suffering from a head cold and "medicine head" and I was trying to remember a quote and that is the closest I could come. "Inferior" doesn't work.

    Thanks for discussing this with me - Taking my "medicine head" to bed.

    steph
  12. by   Simplepleasures
    Quote from jackson145
    It sounds like you've worked at my place. Anyone who even mentions that something might need changed gets labeled as a trouble maker. Even if they are doing it against "the rules", they ones who get done on time are the blessed ones. The ones who sacrifice their health and sanity to play by the rules end up being forced out by the powers that be. I've seen this at a lot of places. It's really sad that it has to be that way.
    Yes, there is a PANDEMIC in LTC across the country,its damn sad.Doesnt HAVE to be this way, but will be this way unless we come out of our stupor and stop blaming the nurse, first step, get PROTECTION, good laws, good unions, then you and I and LTC nurses across the country can take a stand for improved conditions in LTC for the resident and the nurse.
  13. by   labelle
    i agree with stevielynn, the best thing is to call the doc and let him naw abt the situation. it aint that hard to change a 9pm med to 4pm.esp the vitamins and stool stoftners.
    but till that is done, i would stick with the MAR giving meds an hour before or
    an hour after which is ok.
    i wouldnt advice anybody to do what other pple are doin, do wat u naw is right, wen u get busted, it will be you alone and ur license, remember how hard u worked to get that license, im sure u wouldn't be too happy to lose ur license jus because u din wanna follow the MAR!!!

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